Thousands of seniors miss out on Medicare drug help

More qualify, should apply for 'extra help' subsidies this year

Tens of thousands of South Florida seniors are passing up as much as $3,900 a year in Medicare help paying for their prescription drugs because they are eligible but have not applied.

What's more, the government changed the law this year to make it easier to qualify. So this week the Social Security Administration chief for the nation's Southeast urged seniors to fill out the form to get the "extra help."

"People don't fully understand the benefits they would receive," Regional Commissioner Paul D. Barnes said during an interview that is part of a campaign to encourage seniors to apply. "I don't know anyone who would say 'I don't want $3,900 in benefits on my prescription drug coverage.' "

The program, known as the low-income subsidy, covers all or part of what seniors pay for drug coverage, from monthly premiums of their drug plans to annual deductibles to drug co-payments.

Seniors qualify if their annual income falls below $16,245 for an individual or $21,855 for a married couple living together, and if their assets fall below $12,510 for an individual or $25,010 for a couple. Assets include investments but not a house or car.

This year, the government has stopped counting as assets the value of insurance policies. And room and board payments seniors receive from a dependent person are also no longer considered income. The idea of those changes was to turn down fewer people who apply, Barnes said. The changes — promoted with ads featuring Chubby Checker — led 1 million people to apply so far this year, 300,000 more than the same period last year.

The government has been struggling to get seniors to sign up for the subsidy since Medicare drug coverage began in 2006. More than 10 million seniors are eligible, but Medicare has estimated 2.5 million of them are not enrolled. The Congressional Budget Office estimated 4.4 million not enrolled. That works out to possibly 250,000 in Florida and 50,000 in South Florida.

Local officials who try to find those seniors and sign them up, said people often don't enroll because they don't know about it, don't want to disclose their financial details or don't like taking federal assistance.

"A lot of times, they think I'm a telemarketer from an HMO. They can't understand why we're trying to give them something nice. They are suspicious and that's good," said Ginny Jordan, a Social Security outreach worker in Broward County.

Regina Fiedorowitz calls the resistance "foolish." The widow living near Boynton Beach takes the cancer drug Gleevec that can cost as much as $3,500 a month. With extra help, she pays $6.30 for a month's worth of Gleevec or any brand name drug.

"I would be the first one to say they should apply," Fiedorowitz said. "If they don't try to get something to help themselves when they are eligible for it, I don't understand why they don't do it."

In another plus this year, Social Security will send the state the names of all who qualify for extra help, to see if they also qualify for Florida's Medicare Savings Programs that can pay for all or part of a senior's Medicare Part B premium of $96.40 per month.

"Even if you were turned down in the past, you can try again, especially if your circumstances have changed," Vicki Gottlich, senior policy attorney at the nonprofit Center for Medicare Advocacy.